Even 20 years ago politics was trumping science

Geoffrey Kabat writes:

In 2003, UCLA epidemiologist James Enstrom and I published a study of environmental tobacco smoke (ETS)—also called “secondhand smoke” or “passive smoking”—in the British Medical Journal (BMJ). Using data from the American Cancer Society’s prospective study of 1 million adults, we concluded that ETS exposure was not associated with increased mortality.

Since that conclusion flew in the face of the conventional wisdom that had long driven state and local bans on smoking in public places, our study understandably sparked a controversy in the public health community. But the intensity of the attack on us in the pages of a medical journal—by critics who were certain that our study had to be wrong but typically failed to provide specific evidence of fatal errors—vividly illustrates what can happen when policy preferences that have taken on the status of doctrine override rational scientific debate.

We see this in so many other areas of science. Findings that contradict policy preferences are often attacked by scientists.

The response to our paper was largely political. This was evident from the fact that the ACS attacked the paper during the two-day embargo period, before it went online. The clear intent was to delegitimize the study in the court of public opinion. This initial attack invited others to pile on, alleging flaws in our methods. But as the BMJ‘s editors pointed out, those charges generally were not backed by any reference to actual data from the paper.

The head epidemiologist at the ACS condemned our paper as tobacco industry “disinformation,” and other tobacco control activists went even further, citing our paper in a federal racketeering case against cigarette companies. They alleged that the paper was part of a tobacco industry conspiracy to discredit scientific evidence concerning the hazards of smoking. This use of lawfare rather than open scientific debate seemed designed to have a chilling effect on researchers studying passive smoking, discouraging them from reporting politically inconvenient results.

The organizers of this attack felt it necessary to portray us as corrupt agents of the tobacco industry, even though we had long track records researching the effects of smoking and other questions in public health. Our paper included a 200-word declaration stating that the tobacco industry had no involvement with the paper.

We saw similar with the Covid-19 science. Anyone who deviated from the accepted line was pilloried.

The new paper from the American Cancer Society, published last April in CA: A Cancer Journal for Clinicians, comes 21 years after the brouhaha over our BMJ paper and sheds further light on the controversy. This major ACS paper aims to further reduce the incidence of cancer by providing data that can be used to improve policies and practices. …

The “population-attributable fraction” (PAF)—that is, the share of cancer deaths that could be prevented if a given risk factor were removed—is 28.5 percent for cigarette smoking and 0.7 percent for secondhand smoke—a 41-fold difference. Although the PAF for secondhand smoke is statistically significant, the magnitude of the risk is negligible and similar to the risk estimate in our BMJ paper.

So the ACS attacked the paper 21 years ago, but has now just released its own study that backs it up.

For the scientific enterprise to succeed, unpopular findings must be discussed objectively, rather than dismissed summarily as obviously wrong. Leveling ad hominem attacks at researchers for alleged pro-industry bias is no substitute for a rigorous and fair-minded analysis of the data.

The part in bold should be nailed up on the wall of the Royal Society.

One can of course still make a good policy case for banning smoking in enclosed areas, even if the risk of actual cancer or heart disease from second hand smoke is low. You can make a policy case on the basis it is very unpleasant for people to be subject to second hand smoke on the basis of irriting the eyes, making you cough, the smell etc.

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